Background: There are very few reports in the literature that directly address nonunion in children. The current study aimed to present a series of long bones nonunion in children following fractures and corrective osteotomies. Methods: This was a retrospective study that included pediatric patients diagnosed with nonunion following long bone fractures or corrective osteotomies. Patients with nonunion following femoral neck or lateral humeral condyle fractures were excluded. The clinical and radiological records were retrospectively analyzed. Results: Eight patients developed nonunion after fractures, while four patients had nonunion after corrective osteotomies. The mean age at the time of surgical procedure for nonunion was 10.8 years (range, 2 - 18). The tibia was the most common bone complicated by nonunion with 8 cases (66.6%). The mean time to diagnosis of nonunion was 7.9 months (range, 4 - 24). Five patients (41.6%) had multiple fractures or osteotomies. Two patients (16.6%) had a neurological deficit. Conclusion: Pediatric nonunion is a rare entity. Possible risk factors include older children, open fractures, and co-existing neurological disorders. Further studies that include a comparative group and adequate sample size are needed to confirm these findings.
Khalifa, Rami; Amr Abdelgawad; and Ahmed M. Thabet. "Aspetic Nonunion of Long Bones in Children: A Report of Twelve Cases." Western Journal of Orthopaedics 9, 1 (2020). https://digitalrepository.unm.edu/wjo/vol9/iss1/30